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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 4
Apr.  2024
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Article Contents

Changing trend of the disease burden of liver cirrhosis in China from 1990 to 2019

DOI: 10.12449/JCH240414
Research funding:

Joint Support Force 940 Hospital In-hospital Project (2022yxky016);

Gansu Provincial Clinical Medical Research Center for Non infectious Liver Diseases (21JR7RA017)

  • Received Date: 2023-09-20
  • Accepted Date: 2023-10-16
  • Published Date: 2024-04-25
  •   Objective  To investigate the prevalence of liver cirrhosis and the changing trend of the disease burden of liver cirrhosis in the Chinese population from 1990 to 2019, and to provide a data reference for formulating the prevention and treatment strategies for liver cirrhosis in China.  Methods  The Global Burden of Disease Study 2019 was used to collect the data on the incidence rate, mortality rate, disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) of liver cirrhosis. The Joinpoint regression model was used to analyze the changing trend of disease burden; the age-period-cohort (APC) model was used to evaluate age, period, and cohort effects; R software BAPC package was used to predict future changes in disease burden.  Results  From 1990 to 2019 in China, there were increases in the numbers of liver cirrhosis cases and prevalent cases in the general population, as well as in the male and female populations, while there was a reduction in the number of deaths. From 1990 to 2019, the standardized incidence rate, standardized prevalence rate, and standardized mortality rate of liver cirrhosis in the Chinese population showed a downward trend, with a mean annual reduction of 0.62% (95% confidence interval [CI]: -0.74% to -0.50%, t=9.99, P<0.001), 0.44% (95%CI: -0.53% to -0.35%, t=13.18, P<0.001), and 3.02% (95%CI: -3.12% to -2.93%, t=7.58, P<0.001), respectively. From 1990 to 2019, the standardized DALY, YLL, and YLD rates of liver cirrhosis in the Chinese population also showed a downward trend, with a mean annual reduction of 3.27% (95%CI: -3.37% to -3.18%, t=6.22, P<0.001), 3.32% (95%CI: -3.42% to -3.22%, t=9.31, P<0.001), and 1.42% (95%CI: -1.49% to -1.34%, t=4.93, P<0.001), respectively. From 1990 to 2019, the incidence rate of liver cirrhosis in the Chinese population first increased and then decreased with age, while the mortality rate showed an increasing trend, and the risks of disease onset and death showed a decreasing trend with time and birth cohort. The predictive model showed that the standardized incidence rate, prevalence rate, mortality rate, and DALY rate of liver cirrhosis in China will show a decreasing trend from 2020 to 2030. Alcohol was the most important risk factor for both male and female populations, followed by medication.  Conclusion  The disease burden of liver cirrhosis in China shows a decreasing trend from 1990 to 2019, with sex and age differences, especially in the middle-aged male population. Effective measures should be taken for intervention.

     

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  • [1]
    PAROLA M, PINZANI M. Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues[J]. Mol Aspects Med, 2019, 65: 37- 55. DOI: 10.1016/j.mam.2018.09.002.
    [2]
    DEVARBHAVI H, ASRANI SK, ARAB JP, et al. Global burden of liver disease: 2023 update[J]. J Hepatol, 2023, 79( 2): 516- 537. DOI: 10.1016/j.jhep.2023.03.017.
    [3]
    XU XY, DING HG, LI WG, et al. Chinese guidelines on the management of liver cirrhosis(abbreviated version)[J]. World J Gastroenterol, 2020, 26( 45): 7088- 7103. DOI: 10.3748/wjg.v26.i45.7088.
    [4]
    HUANG DQ, MATHURIN P, CORTEZ-PINTO H, et al. Global epidemiology of alcohol-associated cirrhosis and HCC: Trends, projections and risk factors[J]. Nat Rev Gastroenterol Hepatol, 2023, 20( 1): 37- 49. DOI: 10.1038/s41575-022-00688-6.
    [5]
    HUANG DQ, TERRAULT NA, TACKE F, et al. Global epidemiology of cirrhosis- aetiology, trends and predictions[J]. Nat Rev Gastroenterol Hepatol, 2023, 20( 6): 388- 398. DOI: 10.1038/s41575-023-00759-2.
    [6]
    2019 VIEWPOINT COLLABORATORS GBD. Five insights from the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396( 10258): 1135- 1159. DOI: 10.1016/S0140-6736(20)31404-5.
    [7]
    2019 RISK FACTORS COLLABORATORS GBD. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396( 10258): 1223- 1249. DOI: 10.1016/S0140-6736(20)30752-2.
    [8]
    KIM HJ, FAY MP, FEUER EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates[J]. Stat Med, 2000, 19( 3): 335- 351. DOI: 3.0.co;2-z">10.1002/(sici)1097-0258(20000215)19: 3<335: aid-sim336>3.0.co;2-z.
    [9]
    LI HZ, DU LB. Application of Joinpoint regression model in cancer epidemiological time trend analysis[J]. Chin J Prev Med, 2020, 54( 8): 908- 912. DOI: 10.3760/cma.j.cn112150-20200616-00889.

    李辉章, 杜灵彬. Joinpoint回归模型在肿瘤流行病学时间趋势分析中的应用[J]. 中华预防医学杂志, 2020, 54( 8): 908- 912. DOI: 10.3760/cma.j.cn112150-20200616-00889.
    [10]
    XU D, HU JC, WANG SY, et al. Trends in the prevalence of hypertensive heart disease in China from 1990 to 2019: A joinpoint and age-period-cohort analysis[J]. Front Public Health, 2022, 10: 833345. DOI: 10.3389/fpubh.2022.833345.
    [11]
    ZHENG RS, CHEN WQ. Introduction of age-period-queue prediction model based on Bayesian method[J]. Chin J Prev Med, 2012, 46( 7): 648- 650. DOI: 10.3760/cma.j.issn.0253-9624.2012.07.016.

    郑荣寿, 陈万青. 基于贝叶斯方法的年龄-时期-队列预测模型的介绍[J]. 中华预防医学杂志, 2012, 46( 7): 648- 650. DOI: 10.3760/cma.j.issn.0253-9624.2012.07.016.
    [12]
    ROSENBERG PS. A new age-period-cohort model for cancer surveillance research[J]. Stat Methods Med Res, 2019, 28( 10-11): 3363- 3391. DOI: 10.1177/0962280218801121.
    [13]
    HUA SM. Application and development of“age-period-queue” effect model[J]. China CIO Issues, 2019( 9): 73- 74. DOI: 10.3969/j.issn.1001-2362.2019.09.046.

    华淑名.“年龄-时期-队列” 效应模型的应用与发展[J]. 信息系统工程, 2019( 9): 73- 74. DOI: 10.3969/j.issn.1001-2362.2019.09.046.
    [14]
    2017 CIRRHOSIS COLLABORATORS GBD. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet Gastroenterol Hepatol, 2020, 5( 3): 245- 266. DOI: 10.1016/S2468-1253(19)30349-8.
    [15]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association, et al. Guidelines for the prevention and treatment of chronic hepatitis B(version 2022)[J]. J Pract Hepatol, 2023, 26( 3): 457- 478. DOI: 10.3969/j.issn.1007-8134.2023.01.01.

    中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2022年版)[J]. 实用肝脏病杂志, 2023, 26( 3): 457- 478. DOI: 10.3969/j.issn.1007-8134.2023.01.01.
    [16]
    LIU ZH, LIANG XE, HOU JL. Thoughts on expert opinion on expanding antiviral therapy for chronic hepatitis B[J]. J Clin Hepatol, 2023, 39( 1): 14- 21. DOI: 10.3969/j.issn.1001-5256.2023.01.002.

    刘智泓, 梁携儿, 侯金林. 关于《扩大慢性乙型肝炎抗病毒治疗的专家意见》的几点思考[J]. 临床肝胆病杂志, 2023, 39( 1): 14- 21. DOI: 10.3969/j.issn.1001-5256.2023.01.002.
    [17]
    WANG GS, XIE W, WAN G, et al. Diseases spectrum changes of inpatients with liver diseases in a general hospital during 15 years[J/OL]. Chin J Exp Clin Infect Dis Electron Ed, 2021, 15( 1): 29- 36. DOI: 10.3877/cma.j.issn.1674-1358.2021.01.006.

    王桂爽, 谢雯, 万钢, 等. 某综合医院15年间肝病住院患者疾病谱变化分析[J/OL]. 中华实验和临床感染病杂志(电子版), 2021, 15( 1): 29- 36. DOI: 10.3877/cma.j.issn.1674-1358.2021.01.006.
    [18]
    CHEN QQ, RUI FJ, NI WJ, et al. Research progress in epidemiology and risk factors of primary liver cancer[J]. Chin Gen Pract, 2024, 27( 6): 637- 642. DOI: 10.12114/j.issn.1007-9572.2023.0479.

    陈倩倩, 芮法娟, 倪文婧, 等. 原发性肝癌的流行病学及其危险因素研究进展[J]. 中国全科医学, 2024, 27( 6): 637- 642. DOI: 10.12114/j.issn.1007-9572.2023.0479.
    [19]
    LI YR, WANG M, HE FL, et al. Etiological and non-etiological therapies for cirrhotic portal hypertension[J]. J Clin Hepatol, 2022, 38( 6): 1224- 1228. DOI: 10.3969/j.issn.1001-5256.2022.06.003.

    李悦榕, 王民, 何福亮, 等. 肝硬化门静脉高压的病因和非病因治疗[J]. 临床肝胆病杂志, 2022, 38( 6): 1224- 1228. DOI: 10.3969/j.issn.1001-5256.2022.06.003.
    [20]
    FALLOWFIELD JA, JIMENEZ-RAMOS M, ROBERTSON A. Emerging synthetic drugs for the treatment of liver cirrhosis[J]. Expert Opin Emerg Drugs, 2021, 26( 2): 149- 163. DOI: 10.1080/14728214.2021.1918099.
    [21]
    PATEL R, MUELLER M. Alcoholic Liver Disease[EB/OL].( 2023-7-23). https://www.ncbi.nlm.nih.gov/books/NBK546632/. https://www.ncbi.nlm.nih.gov/books/NBK546632/
    [22]
    WANG SY, DONG C, CHANG CD, et al. Opportunities and challenges of surveillance for liver cancer in primary care institutions in China[J]. Chin Gen Pract, 2023, 26( 36): 4498- 4504, 4520. DOI: 10.12114/j.issn.1007-9572.2023.0337.

    王世越, 董晨, 常楚迪, 等. 中国原发性肝癌基层筛查的机遇与挑战[J]. 中国全科医学, 2023, 26( 36): 4498- 4504, 4520. DOI: 10.12114/j.issn.1007-9572.2023.0337.
    [23]
    TONG YN, ZHENG JM, HAN D, et al. Analysis of etiology and clinical characteristics in 986 patients with liver cirrhosis[J]. Chin Hepatol, 2022, 27( 8): 871- 873, 880. DOI: 10.14000/j.cnki.issn.1008-1704.2022.08.008.

    佟印妮, 郑吉敏, 韩丹, 等. 986例肝硬化患者病因及临床特点分析[J]. 肝脏, 2022, 27( 8): 871- 873, 880. DOI: 10.14000/j.cnki.issn.1008-1704.2022.08.008.
    [24]
    LIN Y. Epidemiological Analysis of the Etiology of Cirrhosis in Central China[D]. Wuhan: Huazhong University of Science and Technology, 2022.

    林易. 华中地区肝硬化病因的流行病学变化趋势分析: 单中心研究[D]. 武汉: 华中科技大学, 2022.
    [25]
    HUANG DQ, MATHURIN P, CORTEZ-PINTO H, et al. Global epidemiology of alcohol-associated cirrhosis and HCC: Trends, projections and risk factors[J]. Nat Rev Gastroenterol Hepatol, 2023, 20( 1): 37- 49. DOI: 10.1038/s41575-022-00688-6.
    [26]
    ZHOU EH. The Effect of Drinking on the Progress of Hepatitis B to Cirrhosis[D]. Chongqing: Chongqing Medical University, 2021.

    周恩豪. 饮酒对慢乙肝进展为肝硬化的研究[D]. 重庆: 重庆医科大学, 2021.
    [27]
    BUZZETTI E, PARIKH PM, GERUSSI A, et al. Gender differences in liver disease and the drug-dose gender gap[J]. Pharmacol Res, 2017, 120: 97- 108. DOI: 10.1016/j.phrs.2017.03.014.
    [28]
    YUE TT, ZHANG QQ, CAI T, et al. Trends in the disease burden of HBV and HCV infection in China from 1990-2019[J]. Int J Infect Dis, 2022, 122: 476- 485. DOI: 10.1016/j.ijid.2022.06.017.
    [29]
    LIU YB, CHEN MK. Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions[J]. World J Gastroenterol, 2022, 28( 41): 5910- 5930. DOI: 10.3748/wjg.v28.i41.5910.
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